Therapeutic effect of gastrotomy on lung infection and dystrophy in patients with traumatic vagus nerve injury

Abstract

Objective To examine the occurrence of traumatic lower cranial nerve injury and the therapeutic effect of gastrostomy on vagus nerve injury. Methods Clinical data of 45 patients sustaining traumatic lower cranial nerve injury were retrospectively analyzed. There were 32 males and 13 females, with the age of (34.5±8.8)years. Injury resulted from high falls in 22 patients, traffic accidents in 15 patients and other in 8 patients. Non-operative treatments, nutrition and hormone intervention, improving minicirculation, promoting blood circulation and removing stasis for instance, were performed for the patients with the injury involving the glossopharyngeal nerve (n=12), accessory nerve (n=21) and hypoglossal nerve (n=20). Vagus nerve injury was seen in 32 patients. Fifteen out of the 32 patients underwent gastrotomy and early enteral nutrition support and 17 transnasal gastric catheter indwelling and enteral nutrition support. Lung infection and dystrophy were evaluated after operation. Results Two patients had lung infection and one dystrophy after gastrotomy. In contrast, 9 patients had lung infection and one dystrophy after transnasal stomach intubation surgery (P<0.05). At follow-up, the complications were cured in gastrotomy group, but only 7 lung infection and 5 dystrophy were cured in indwelling catheter group. Conclusions Vagus nerve injury is most common in lower cranial nerve injury and manifested with choking on water and dysphagia. Gastrostomy in combination with early enteral nutrition therapy is effective to improve the nutritional status and reduce lung infection in patients with traumatic vagus nerve injury. Key words: Cranial nerve injuries; Traumatic brain injuries; Vagus nerve; Gastrostomy